HISTOPATHOLOGICAL FINDINGS IN ASCENDING AORTA´S WALL WITH AND WITHOUT DILATATION IN PATIENTS WITH BICUSPID VALVE

CERVETTI, MANUEL; MORALES CELINA; NAVIA, DANIEL; GONZÁLEZ, GERMÁN; AÓN BERTOLINO, MA. LAURA.; MATOSO, MIRIAN

Bilbao

Congreso; European Congress of Pathology; 2018

Sociedad Europea de Patologia

OBJECTIVE: the objective was to match the thickness (E) of the ascending aortas (AAs) with its histopathological findings evaluated in biopsies from patients with and without dilatation and bicuspid valve.METHODS: 184 patients (70% men) with diagnosis of bicuspid valve and surgical valve replacement between 2009 to 2017 were considered. AAs diameter ≤ 40 mm determined by echocardiography was observed in 119 patients while AAs > 40 mm was seen in 65 of them. During the surgical valve replacement, a sample of AAs was obtained and fixed in 10% formaldehyde. The aortic wall thickness was measured with a caliper and each sample was processed, paraffin embedded and stained with H & E, Masson´s trichrome and Alcian blue for optical microscopy evaluation.Histopathological findings of the intimal, adventitia and middle layer (elastic fibers, collagen and smooth muscle, proteoglycans and inflammatory infiltrate) were studied in semi quantitative grade (G) as: G 0 (n: none; without injury); G1 (m: mild; 0-10% of the layer affected); G2 (m-M: mild-Moderate; 11-25% of the layer affected); G3 (M-M: Moderate-Moderate; 26-50% of the layer affected); G4 (s: severe; 51-100% of the layer affected). Thickness of the aortic wall: 1,5 to 3 mm with interval of 0,5 mm.RESULTS: AAs without dilatation: E: 1,51 - 2 mm: 46% of patients with G3 (M-M): 42%; E: 2,01 ? 2,5mm: 8% of patients with G4 (s); E: 2,51 ? 3 mm: 16% of patients with G4 (s): 42%. AAs with dilatation: E: 1,51 - 2 mm: 20% of patients with G3 (M-M): 3% and G4 (s): 15%; E: 2,01 ? 2,5mm: 20% of patients with G3 (M-M): 8% and G4 (s): 11%; E: 2,51 ? 3 mm: 26% of patients with G3 (M-M): 5% and G4 (s): 20%. Thus 70% of the patients with AAs without dilatation presented an E between 1,5 - 3 mm and 96% of them corresponded to G3 (M-M), while in the same range of E the 66% of patients with AAs dilated showed 46% with G4 (s) and 16% with G3 (M-M).CONCLUSION: AAs of patients with bicuspid valves without aortic dilation at the time of surgery presented less injury in the arterial wall as compared with patients with dilated AAs.